Endoscopic surgery, including procedures performed by way of endoscopic instruments such as gastroscopes, colonoscopes, laparoscopes, and the like, may be preferred as an alternative to open surgery due to the many advantages attributed to such “minimally invasive” techniques, such as shortened hospital stays, reduced recovery time, reduced risk of complications, and diminishment of the amount of and/or visibility of scarring caused by a surgical intervention. In many endoscopic procedures, as in open surgery, there are instances where a surgeon may desire to repair damaged or diseased tissues by apposing the tissues together using a suture. However, the suturing devices, stapling devices, and other fastener applicators that have been developed to aid surgeons performing open surgery generally cannot be easily redesigned to be passed through a flexible endoscopic instrument, which may have a working channel having an internal diameter in the range of about 2.0 to 4.0 millimeters.
To address these problems, various suture anchors and applicator devices have been developed to permit surgeons to endoscopically emplace sutures within tissues. Such suture anchors may be deployed using applicator devices that are inserted within and extended through the working channel of an endoscope, carrying a suture anchor to the site of repair. The suture anchor typically has suture attached thereto. The length of suture required to extend through the applicator device and into the body can be long, and the suture can get knotted or tangled en route to and/or in the body, thereby prolonging the surgical procedure while the suture is repaired or replaced. The applicators typically include a cannulated needle portion which permits the surgeon to penetrate the tissues adjacent to diseased or damaged tissue and to deploy the suture anchor into the tissue to be apposed in a repair. Such needle penetration presents the risk that nearby organs may be accidentally injured by the needle of the applicator. A physician normally cannot see anatomical structures on the distal side of the tissue layers when the needle is being pushed through the tissue layers. Therefore, there is a risk that adjacent organs may be accidentally injured by the penetrating needle.
Accordingly, there remains a need for methods and devices for deploying suture anchors with improved suture management and decreased chances of damaging adjacent tissue.